Intrapartum cardiotocography – the dilemma of interpretational variation

Palomäki, Outi; Luukkaala, Tiina; Luoto, Riikka; Tuimala, Risto

doi:10.1515/jpm.2006.057

Cited by 92 publications

(50 citation statements)

References 32 publications

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“…6 Moreover, there is interobserver variation in interpretation of abnormal cardiotocography readings and recommendations for interventions. 7 The study done in 2000 at Lady Dufferin Hospital Karachi, showed that the Apgar score less than 7 at 1 minute in 64.15% cases, and it was more than 7 at 1 minute in 35.84%. It remained less than 7 at 5 minute in 18.86% only, while in 81.13% it improved or stayed constant in pathological CTG group.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Abnormal Cardiotocography and Fetal Outcome

Banu

2016

Nepal j. obstet. gynaecol.

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Section: Introductionmentioning

confidence: 99%

Relationship between Abnormal Cardiotocography and Fetal Outcome

Banu

2016

Nepal j. obstet. gynaecol.

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“…The original purpose of continuous electronic foetal heart monitoring during labour to monitor the foetus to prevent intrapartum still birth and perinatal morbidity. 4 Intrapartum monitoring tool with high accuracy is required to ensure foetal well-being in labour. Intermittent auscultation of FHR and electronic foetal monitoring such as cardiotocography are most popular methods for intrapartum foetal surveillance, whereas the former focuses only on estimation of basal heart rate, the latter also reflects upon other qualities of foetal heart rate such as variability, accelerations and decelerations.…”

Section: Introductionmentioning

confidence: 99%

Study on umbilical cord arterial blood gas analysis and cord blood lactate levels as predictors for adverse neonatal outcome: an observational study

Patil

Sukanya

Rath

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Perinatal asphyxia is a major cause of neonatal and childhood morbidity and mortality. Electronic foetal monitoring is used routinely to know the condition of the baby during Intrapartum period. Normal trace correlates highly with absence of acidemia at birth. Abnormal trace needs further evaluation. In order to better define the metabolic status of the new born, umbilical lactate levels have been measured. Objectives of this study were to determine the validity of umbilical cord blood lactate levels in predicting the adverse early neonatal outcome in babies with intrapartum foetal distress and to compare the validity of umbilical cord blood lactate and umbilical artery pH in predicting adverse neonatal outcome in babies with intrapartum foetal distress.Methods: 295 pregnant women with abnormal CTG in active labour were subjected for estimation of cord blood lactate and umbilical artery pH immediately after delivery and were compared in predicting adverse neonatal outcome.Results: In the present study specificity of serum lactate (97.7%) and umbilical artery pH (95.97%) was almost similar in babies with Apgar <7 at 1 minute and 5 minutes, but sensitivity of serum lactate (23.14%) and cord ph (31.4%) was less in babies with Apgar score ≤7 at 1 minute. Area under ROC showed serum lactate is more accurate in predicting adverse neonatal outcome compared to umbilical artery pH.Conclusions: Umbilical cord blood lactate is more specific than umbilical artery pH in predicting adverse neonatal outcome. Area under ROC (at 95th percentile) shown serum lactate is more accurate in predicting adverse neonatal outcome compared to umbilical artery pH at birth.

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“…Computer analysis of CTGs was introduced in the 1980s [9,17,21,24] in an attempt to overcome the subjectivity of visual analysis [3,29] . The fi rst systems were developed for antepartum monitoring, where increased baseline stability, lower signal loss and artefacts and reduced tracing length pose less challenges for signal processing and algorithm development.…”

Section: Discussionmentioning

confidence: 99%

“…Several systems for central monitoring of fetal signals have been developed to provide simultaneous display of multiple tracings on the same computer screen, in one or several locations, thereby allowing easier monitoring of signals. The need to handle digital signals has also allowed the incorporation of computer analysis of the FHR into several of them, with the aim of overcoming the well-known poor reliability of visual analysis [3,29] to prompt healthcare professionals to act on changes that are allegedly associated with fetal hypoxia.…”

Section: Introductionmentioning

confidence: 99%

An overview of central fetal monitoring systems in labour

Nunes¹,

Ayres-de-Campos²,

Figueiredo

et al. 2012

Journal of Perinatal Medicine

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A variety of systems for centralised viewing of fetal signals during labour are currently available, allowing simultaneous monitoring of multiple tracings in one or more locations. Display of maternal vital signs, ST signals and an electronic partogram are available in the majority of these systems. A few of them have incorporated computer analysis of cardiotocographic signals or combined cardiotocographic and ST data analysis. Computer analysis may elicit real-time alerts for healthcare professionals when changes associated with fetal hypoxia are detected. Central fetal monitoring systems have been installed in a large number of maternity hospitals in industrialised countries, but there is still limited evidence of their impact on perinatal indicators, on the behaviour of healthcare professionals and on related health costs.

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Intrapartum cardiotocography – the dilemma of interpretational variation

Abstract: Inter-observer variation in interpretation of abnormal CTG readings and recommendations for intervention is relatively wide. To improve reliability, uniform classification and standardized training in CTG interpretation are needed, as well as increased use of computerized CTG.

Cited by 92 publications

References 32 publications

Relationship between Abnormal Cardiotocography and Fetal Outcome

Relationship between Abnormal Cardiotocography and Fetal Outcome

Study on umbilical cord arterial blood gas analysis and cord blood lactate levels as predictors for adverse neonatal outcome: an observational study

An overview of central fetal monitoring systems in labour

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